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Skiing May Lead to Bum Knee

Shin bone injury more common than suspected

MONDAY, July 9, 2001 (HealthDayNews) -- Here's food for thought the next time you hit the slopes: Skiing may be tougher on legs than doctors realized.

Researchers in Colorado's resort country found that knee fractures -- a type of broken leg -- are eight times more common than previously thought.

They also discovered that skiers with basic experience may be in more danger of injury than beginners or daredevils. "When you think of someone breaking their leg, you think they have to be going pretty fast and on a steep slope," said Dr. Peter Millett, an orthopedic surgeon in Vail, Colo. "It can happen to the average person on the average run. It's something that everyone's at risk for."

Skiers suffer an estimated 600,000 injuries a year in the United States, and as many as 200,000 involve the knee, said experts.

Millett and colleagues at Vail's Steadman Hawkins Sports Medicine Foundation examined 110 consecutive tibial plateau fractures, in which the bone below the knee -- the shin bone -- was broken. That injury was estimated to make up less than 1 percent of all ski injuries, though recent experience suggested the percentage is higher.

"We noticed that we were seeing a lot of these injuries, and we wanted to figure out if we could understand why there was an increased number of incidents," Millett said.

While rare, shin fractures can cause serious health problems, Millett said. "It usually requires surgery to have them fixed because the fracture extends into the [knee] joint."

All the fractures occurred in or near Vail during the 1998-1999 ski season. Researchers reported their findings at this month's meeting of the American Orthopaedic Society for Sports Medicine in Keystone, Colo.

Most injuries involved intermediate-level skiers on intermediate slopes. Many injuries occurred in the afternoon when snow conditions were less ideal, and skiers were tired.

Women were three times more likely to suffer the fractures as men, but the injuries in males were generally more severe. "The more serious injuries occurred in younger men. Maybe they weren't reckless but were just skiing at a higher speed," Millett said.

Women may have suffered more fractures because their bones are weaker, he said. "For example, there's a lot of women in New York City who suffer this type of fracture when they get hit by a taxicab."

Millett said he wasn't sure why beginners and expert skiers didn't get more injuries. Perhaps, he said beginners don't ski fast enough to create the injuries, and experts were more likely to injure other bones.

The increased use of parabolic skis may explain why the injury rates appeared to have risen, he said. This kind of ski is shaped more like an hourglass than normal skis, and they tend to "grab" instead of skid when hitting a bump, said ski experts. Another theory is that hospitals are doing a better job of reporting incidents, Millett said.

Luckily, medical advances over the last 25 years have greatly changed how knee injuries are treated at hospitals near ski slopes, said Dr. Robert Averill, an orthopedic surgeon at Scripps Mercy Hospital in San Diego.

MRI scans allow doctors to get a much more sophisticated view of broken bones in the leg. And doctors can treat the fractures by installing plates and screws during surgery, he said.

Before the mid-1970s, doctors put pins into legs, which didn't allow as much flexibility in the joints, he said.

What To Do

Like your legs? Try snowboarding. While snowboarders also are injured, Millett said snowboarding is much safer for knees because your legs rarely will go in separate directions and cause a fracture.

Learn more about ski injuries in this fact sheet from the Far West Ski Association.

Do you know the art of falling properly on a ski slope? Learn about it in this list of ski safety tips from Sportsknee.com.

SOURCES: Interviews with Peter J. Millett, M.D., M.Sc., Steadman Hawkins Clinic, Vail, Colo., and Robert Averill, M.D., orthopedic surgeon, Scripps Mercy Hospital, San Diego; July 2001 meeting of the American Orthopaedic Society for Sports Medicine in Keystone, Colo.
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